This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. The site was deactivated on July 1, 2013, so the post has been reproduced here.

STUDIES SHOW GROWING ANTI-FAT BIASES FOR OVERWEIGHT CHILDREN AND ADULTS

Two-thirds of Americans are overweight or obese. We reached the point where the majority of us were exceeding our healthy weight in the 1990s. We also have very high rates of fat prejudice in this country. So the question that begs to be answered is, if the majority of Americans have been bigger than average for the past 20 years or so, who is perpetuating the anti-fat bias?

Anyone who has ever circulated a fat joke via email or liked one on Facebook can raise a hand.

Two studies published this month made me think it’s time to turn the mirror on ourselves.

It Takes A Village

Long before children have the math skills to calculate their body mass index (weight/height2 x 703) they show an aversion towards overweight children as playmates. (Body mass index, or BMI, is a measurement used to determine one’s weight classification. A BMI below 20 is considered underweight, between 20-25 normal weight, 26-29 overweight and above 30 is obese.)

Researchers at the University of Leeds in England found children aged 4 and 7 would select a normal weight child or one in a wheelchair before choosing an overweight child as a friend. The scientists discovered this through the use of illustrated storybooks. They created three versions of a story, each with a central character named Alfie. He was either normal weight, overweight or in a wheelchair in the different versions. After hearing and seeing the stories the children in each group were asked if they would befriend Alfie. They were far more likely to choose normal weight or disabled Alfie, with just one out of 43 children saying they would like overweight Alfie as their friend.

The same experiment was done with a female character named Alfina and produced similar results. In both cases older children expressed more negative views towards the overweight child, including seeing him or her as less likely to win a race, do good school work or get invited to parties.

These findings suggest children pick up on the social stigma against overweight people from adults and the media at a very young age as. The authors of the study concluded, “We have a real habit of equating fatness with bad and children are reflecting that back to us.”

Physicians Against Fatness

The second study on fat prejudice that came across my desk this week was done on medical students. It didn’t involve story books.

Researchers at the Wake Forest School of Medicine in Winston-Salem, North Carolina had over 300 third year medical students complete the Weight Implicit Association Test (IAT). This test is a validated measure of implicit preferences for “fat” or “thin” individuals.

The value in measuring implicit biases is that they occur at an unconscious level. They reflect our first reaction or initial emotional response to someone before our conscious thought emerge.

The students also completed another test to identify their explicit preferences, which are the ones we are consciously aware of.

The results showed that the majority of students had implicit weight-related biases, with more than twice as many showing anti-fat bias compared to anti-thin. The majority also reported they preferred thin people to fat people in the explicit test, with males twice as likely to report explicit anti-fat bias. Among students with a significant weight-related bias, only 23% were aware of it. More than two-thirds of them thought they were neutral.

The authors suggest these findings may be due, in part, to the fact medical students are learning about the dangers of obesity and may feel they should prefer thin people over fat. Or they may believe body weight is under an individual’s control so they may hold a negative view of someone who doesn’t do something about it.

Unfortunately, these results are very similar to those obtained when non-medical students take the tests, and they reflect the attitudes of the general public. Even those of kids in kindergarten.

Lead author Dr. David Miller said these biases can affect the doctor-patient relationship and must be overcome to improve care for the millions of Americans who are overweight or obese.